Background: Non Productive Time OT causes potential loss or deferment of revenue for the hospital and internal customer dissatisfaction. The quality tool Lean Six Sigma may help to reduce the non-productive time.
Aim: To use elements of a six sigma model to reduce non-productive time in Gastro Intestine Surgery OT. It focuses on the reduction of NPT between Patient In time and Induction Begin time, Induction End time and Incision In time, Patient Out time and OT Readiness Time.
Method: In a five phase study using DMAIC (Define. Measure, Analyze, Implement & Control) model, business case, value analysis, brain storming, FMEA (Failure Mode & Effect Analysis), RPN (Risk Priority Number) calculation identified causes and solutions. In six sigma analysis process sigma, target sigma and achieved sigma was calculated.
Results: The null hypothesis of no difference in old and new Non Productive Time between Patient In time and Induction Begin time, between Induction End time and Incision and between Patient Out Time and OT Readiness Time was rejected using 2test since the p-value was below 0.05 at 95% confidence level. The process sigma was at 0.91, 0.96 and 0.67 which got improved to 2.55, 2.22 and 3.28 which was better than target Six sigma. Overall bottom line improvement was 4.8CR for the study period by bringing efficiency in the system.
Conclusion: The six sigma project in OT resulted in reducing NPTs, helping to take more cases, patient discharge becoming more systematic, and reducing chaos regarding scheduling OT cases.

Objective: Health being a subject of the state and Accreditation of Healthcare Organisations being a voluntary process, the Quality Council of India (QCI) through National Accreditation Board for Hospitals and Healthcare Providers is creating standards and promoting quality in healthcare. The Medical Laboratory Program, which is designed to improve the Quality of Medical Laboratories, is being implemented by both government and private Laboratories to ensure quality of test results.
Materials and Methods: A small program Evaluation study was carried out over a period to understand the level of understanding, usefulness and feedback from the participating Laboratories regarding "QCI - Essential Standards for Medical Laboratories"1 Program. The data was collected and analysed from 55 participating laboratories.
Results: The study findings indicated 100% strongly agree that, training programs conducted were really helpful, 98% stated that, this program was instrumental towards Patient Safety and improved the Quality Indicators of laboratory activities. Around 89% of the respondents strongly support the fact that "Educational Materials & technical Supports provided by Med-Lab Team were very useful & helpful to implement the standards" & this Program has helped to "achieve Quality Output with minimal effort & investment". Most of the respondents (4/5 th ) i.e. 80% of the respondents found that implementation of Med-Lab Program was easy & flexible. More than 80% of the respondents have felt either good, very good or excellent on all the parameters that have been spelt out regarding "Post-Implementation impact of Med-Lab Program on various quality Indicators. 53 labs (96%) are satisfied with results on post implementation of the Med-Lab Program and agreed to recommend this program to other labs as well.
This is the first such study in India. The findings may be an eye opener for the labs and the state governments who haven't yet participated in the Med Lab Program.

Assessing Indian Public Health Standards for 24 × 7 primary health centers: A case study with special reference to newborn care services

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Prahlad Rai Sodani, Kalpa SharmaDOI:10.4103/2348-6139.132919

Objectives: The main objective of the present study is to identify the existing gap with respect to Indian Public Health Standards (IPHS) for availability of infrastructure, human resources, investigative services and essential newborn care services at 24 × 7 primary health centers (PHCs) of Bharatpur district of Rajasthan state.
Materials and Methods: Data were collected from medical officer in-charge from the study 24 × 7 PHCs to provide required data on infrastructure, human resources, investigative services and newborn health care services through the well-structured questionnaire.
Results: It was found that the availability of operation theater, telephone and E-mail facility were not satisfactory. Labor room was available at almost all the 24 × 7 PHCs while nearly 75% of the 24 × 7 PHCs have laboratory and cold chain facility. Shortage of human resources, especially laboratory technician and pharmacist were observed. It was also observed that none of the 24 × 7 PHCs have fully equipped newborn corner. Conclusion: The study depicted that the availability of human resources, infrastructure and facilities for newborn care services at the 24 × 7 PHCs were not satisfactory as per the prescribed IPHS. Efforts are required on priority to strengthen OT, investigative facilities and communication facilities at the 24 × 7 PHCs.
Recommendations: It is recommended that availability of pharmacist/compounder shall be as per IPHS norms at the 24 × 7 PHCs. New born care corners established at 24 × 7 PHCs should be provided adequate equipment/items as recommended by the IPHS so as to become effective and functional to provide new born care services in the rural areas.